In This Section

Employee Injury Forms

For additional assistance please contact: 301-475-5511 x32110

Employee Statement Form
An Employee's Statement of Accident/Injury/Illness form, which must be completed by an employee and submitted to their supervisor immediately following an incident.
Return to Work Evaluation Form
A form to be completed by a physician to determine an employee's fitness for duty.
Supervisor Accident Report Form
A form used by a supervisor to record details about a reported employee accident, injury, or illness
Acord Automobile Loss Notice
An ACORD Automobile Loss Notice is a standard insurance form, often referred to as an Automobile Loss Notice or First Notice of Loss (FNOL), that documents an auto accident for insurance purposes.

Fiscal Services & Human Resources

Tammy McCourt, CPA
Deputy Superintendent of Fiscal and Supporting Services

Dale Farrell Ed.D.
Chief of Staff

Address
23160 Moakley Street,
Leonardtown, MD 20650

Phone
301-475-5511 ext.32194

Fax
301-475-4201

Email
hrd@smcps.org

Contact for Assistance

Stacey Brown
slbrown@smcps.org
Human Resources Generalist
301-475-5511 ext.32110

Brynn Cosner
btcosner@smcps.org
Insurance & Retirement Accounting Coordinator
301-475-5511 ext.32264

Heather Huff
hrhuff@smcps.org
Fiscal Services Insurance Specialist
301-475-5511 ext.32182